Comparison of the Feasibility and Effectiveness of Transradial Coronary Angiography Via Right Versus Left Radial Artery Approaches (from the PREVAIL Study)
It remains undefined if transradial coronary angiography from a right or left radial arterial approach differs in real-world practice. To address this issue, we performed a subanalysis of the PREVAIL study. The PREVAIL study was a prospective, multicenter, observational survey of unselected consecut...
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| Veröffentlicht in: | The American journal of cardiology 2012-09, Vol.110 (6), p.771-775 |
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| creator | Pelliccia, Francesco, MD Trani, Carlo, MD Biondi-Zoccai, Giuseppe G.L., MD Nazzaro, Marco, MD Berni, Andrea, MD Patti, Giuseppe, MD Patrizi, Roberto, MD Pironi, Bruno, MD Mazzarotto, Pietro, MD Gioffrè, Gaetano, MD Speciale, Giulio, MD Pristipino, Christian, MD |
| description | It remains undefined if transradial coronary angiography from a right or left radial arterial approach differs in real-world practice. To address this issue, we performed a subanalysis of the PREVAIL study. The PREVAIL study was a prospective, multicenter, observational survey of unselected consecutive patients undergoing invasive cardiovascular procedures over a 1-month observation period, specifically aimed at assessing the outcomes of radial approach in the contemporary real world. The choice of arterial approach was left to the discretion of the operator. Prespecified end points of this subanalysis were procedural characteristics. Of 1,052 patients consecutively enrolled, 509 patients underwent transradial catheterization, 304 with a right radial and 205 with a left radial approach. Procedural success rates were similar between the 2 groups. Compared to the left radial group, the right radial group had longer procedure duration (46 ± 29 vs 33 ± 24 minutes, p |
| doi_str_mv | 10.1016/j.amjcard.2012.05.005 |
| format | Article |
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To address this issue, we performed a subanalysis of the PREVAIL study. The PREVAIL study was a prospective, multicenter, observational survey of unselected consecutive patients undergoing invasive cardiovascular procedures over a 1-month observation period, specifically aimed at assessing the outcomes of radial approach in the contemporary real world. The choice of arterial approach was left to the discretion of the operator. Prespecified end points of this subanalysis were procedural characteristics. Of 1,052 patients consecutively enrolled, 509 patients underwent transradial catheterization, 304 with a right radial and 205 with a left radial approach. Procedural success rates were similar between the 2 groups. Compared to the left radial group, the right radial group had longer procedure duration (46 ± 29 vs 33 ± 24 minutes, p <0.0001) and fluoroscopy time (765 ± 787 vs 533 ± 502, p <0.0001). At multivariate analysis, including a parsimonious propensity score for the choice of left radial approach, duration of procedure (beta coefficient 11.38, p <0.001) and total dose–area product (beta coefficient 11.38, p <0.001) were independently associated with the choice of the left radial artery approach. The operator's proficiency in right/left radial approach did not influence study results. In conclusion, right and left radial approaches are feasible and effective to perform percutaneous procedures. In the contemporary real world, however, the left radial route is associated with shorter procedures and lower radiologic exposure than the right radial approach, independently of an operator's proficiency.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2012.05.005</identifier><identifier>PMID: 22651876</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Acute coronary syndromes ; Aged ; Angina pectoris ; Angioplasty, Balloon, Coronary ; Biological and medical sciences ; Cardiac Catheterization - methods ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular system ; Confidence intervals ; Coronary Angiography - methods ; Feasibility Studies ; Female ; Humans ; Intervention ; Intubation ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical imaging ; Medical sciences ; Middle Aged ; Multivariate analysis ; Prospective Studies ; Radial Artery ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Regression analysis ; Studies</subject><ispartof>The American journal of cardiology, 2012-09, Vol.110 (6), p.771-775</ispartof><rights>Elsevier Inc.</rights><rights>2012 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Sep 15, 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c478t-d1287e95aae451c6df7ebabea89f10a6c01f280a38391acca6c9bc5bf85a561a3</citedby><cites>FETCH-LOGICAL-c478t-d1287e95aae451c6df7ebabea89f10a6c01f280a38391acca6c9bc5bf85a561a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914912013343$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26380812$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22651876$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pelliccia, Francesco, MD</creatorcontrib><creatorcontrib>Trani, Carlo, MD</creatorcontrib><creatorcontrib>Biondi-Zoccai, Giuseppe G.L., MD</creatorcontrib><creatorcontrib>Nazzaro, Marco, MD</creatorcontrib><creatorcontrib>Berni, Andrea, MD</creatorcontrib><creatorcontrib>Patti, Giuseppe, MD</creatorcontrib><creatorcontrib>Patrizi, Roberto, MD</creatorcontrib><creatorcontrib>Pironi, Bruno, MD</creatorcontrib><creatorcontrib>Mazzarotto, Pietro, MD</creatorcontrib><creatorcontrib>Gioffrè, Gaetano, MD</creatorcontrib><creatorcontrib>Speciale, Giulio, MD</creatorcontrib><creatorcontrib>Pristipino, Christian, MD</creatorcontrib><creatorcontrib>Prospective Registry of Vascular Access in Interventions in Lazio Region (prevail) Study Group</creatorcontrib><creatorcontrib>Prospective Registry of Vascular Access in Interventions in Lazio Region (PREVAIL) Study Group</creatorcontrib><title>Comparison of the Feasibility and Effectiveness of Transradial Coronary Angiography Via Right Versus Left Radial Artery Approaches (from the PREVAIL Study)</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>It remains undefined if transradial coronary angiography from a right or left radial arterial approach differs in real-world practice. To address this issue, we performed a subanalysis of the PREVAIL study. The PREVAIL study was a prospective, multicenter, observational survey of unselected consecutive patients undergoing invasive cardiovascular procedures over a 1-month observation period, specifically aimed at assessing the outcomes of radial approach in the contemporary real world. The choice of arterial approach was left to the discretion of the operator. Prespecified end points of this subanalysis were procedural characteristics. Of 1,052 patients consecutively enrolled, 509 patients underwent transradial catheterization, 304 with a right radial and 205 with a left radial approach. Procedural success rates were similar between the 2 groups. Compared to the left radial group, the right radial group had longer procedure duration (46 ± 29 vs 33 ± 24 minutes, p <0.0001) and fluoroscopy time (765 ± 787 vs 533 ± 502, p <0.0001). At multivariate analysis, including a parsimonious propensity score for the choice of left radial approach, duration of procedure (beta coefficient 11.38, p <0.001) and total dose–area product (beta coefficient 11.38, p <0.001) were independently associated with the choice of the left radial artery approach. The operator's proficiency in right/left radial approach did not influence study results. In conclusion, right and left radial approaches are feasible and effective to perform percutaneous procedures. In the contemporary real world, however, the left radial route is associated with shorter procedures and lower radiologic exposure than the right radial approach, independently of an operator's proficiency.</description><subject>Acute coronary syndromes</subject><subject>Aged</subject><subject>Angina pectoris</subject><subject>Angioplasty, Balloon, Coronary</subject><subject>Biological and medical sciences</subject><subject>Cardiac Catheterization - methods</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular system</subject><subject>Confidence intervals</subject><subject>Coronary Angiography - methods</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Intervention</subject><subject>Intubation</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Prospective Studies</subject><subject>Radial Artery</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Regression analysis</subject><subject>Studies</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFksGO0zAQhiMEYsvCI4AsIaTl0GLHdZpcQFXVhZUqgbpLr9bEGbcuSVzsZKU-Cy_LhBZW2gsny9Y3__yef5LkteATwUX2YT-BZm8gVJOUi3TC1YRz9SQZiXxWjEUh5NNkxDlPx4WYFhfJixj3dBVCZc-TizTNFIHZKPm18M0Bgou-Zd6ybofsGiG60tWuOzJoK7a0Fk3n7rHFGAfoLkAbA1QOarbwwbcQjmzebp3fBjjsjmzjgK3ddtexDYbYR7ZC27H1qWIeOhz4wyF4MDuM7MoG3_xp_W293MxvVuy266vj-5fJMwt1xFfn8zL5fr28W3wZr75-vlnMV2MzneXduBJpPsNCAeBUCZNVdoYllAh5YQWHzHBh05yDzGUhwBh6KUqjSpsrUJkAeZlcnXTJ0c8eY6cbFw3WNbTo-6gFl7MsS0XBCX37CN37PrTkjqhcTJWkgyh1okzwMQa0-hBcQ1MiSA_p6b0-p6eH9DRXmtKjujdn9b5ssPpX9TcuAt6dAYgGaktBGBcfuEzm5CIl7tOJQxrbvcOgo3HYGqxcoCx15d1_rXx8pGBq1zpq-gOPGB9-rSPV6Nth1YZNEyQi5VTK33HJ0J0</recordid><startdate>20120915</startdate><enddate>20120915</enddate><creator>Pelliccia, Francesco, MD</creator><creator>Trani, Carlo, MD</creator><creator>Biondi-Zoccai, Giuseppe G.L., MD</creator><creator>Nazzaro, Marco, MD</creator><creator>Berni, Andrea, MD</creator><creator>Patti, Giuseppe, MD</creator><creator>Patrizi, Roberto, MD</creator><creator>Pironi, Bruno, MD</creator><creator>Mazzarotto, Pietro, MD</creator><creator>Gioffrè, Gaetano, MD</creator><creator>Speciale, Giulio, MD</creator><creator>Pristipino, Christian, MD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20120915</creationdate><title>Comparison of the Feasibility and Effectiveness of Transradial Coronary Angiography Via Right Versus Left Radial Artery Approaches (from the PREVAIL Study)</title><author>Pelliccia, Francesco, MD ; Trani, Carlo, MD ; Biondi-Zoccai, Giuseppe G.L., MD ; Nazzaro, Marco, MD ; Berni, Andrea, MD ; Patti, Giuseppe, MD ; Patrizi, Roberto, MD ; Pironi, Bruno, MD ; Mazzarotto, Pietro, MD ; Gioffrè, Gaetano, MD ; Speciale, Giulio, MD ; Pristipino, Christian, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c478t-d1287e95aae451c6df7ebabea89f10a6c01f280a38391acca6c9bc5bf85a561a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Acute coronary syndromes</topic><topic>Aged</topic><topic>Angina pectoris</topic><topic>Angioplasty, Balloon, Coronary</topic><topic>Biological and medical sciences</topic><topic>Cardiac Catheterization - methods</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Cardiovascular system</topic><topic>Confidence intervals</topic><topic>Coronary Angiography - methods</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Intervention</topic><topic>Intubation</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Prospective Studies</topic><topic>Radial Artery</topic><topic>Radiodiagnosis. Nmr imagery. 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To address this issue, we performed a subanalysis of the PREVAIL study. The PREVAIL study was a prospective, multicenter, observational survey of unselected consecutive patients undergoing invasive cardiovascular procedures over a 1-month observation period, specifically aimed at assessing the outcomes of radial approach in the contemporary real world. The choice of arterial approach was left to the discretion of the operator. Prespecified end points of this subanalysis were procedural characteristics. Of 1,052 patients consecutively enrolled, 509 patients underwent transradial catheterization, 304 with a right radial and 205 with a left radial approach. Procedural success rates were similar between the 2 groups. Compared to the left radial group, the right radial group had longer procedure duration (46 ± 29 vs 33 ± 24 minutes, p <0.0001) and fluoroscopy time (765 ± 787 vs 533 ± 502, p <0.0001). At multivariate analysis, including a parsimonious propensity score for the choice of left radial approach, duration of procedure (beta coefficient 11.38, p <0.001) and total dose–area product (beta coefficient 11.38, p <0.001) were independently associated with the choice of the left radial artery approach. The operator's proficiency in right/left radial approach did not influence study results. In conclusion, right and left radial approaches are feasible and effective to perform percutaneous procedures. In the contemporary real world, however, the left radial route is associated with shorter procedures and lower radiologic exposure than the right radial approach, independently of an operator's proficiency.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>22651876</pmid><doi>10.1016/j.amjcard.2012.05.005</doi><tpages>5</tpages></addata></record> |
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| subjects | Acute coronary syndromes Aged Angina pectoris Angioplasty, Balloon, Coronary Biological and medical sciences Cardiac Catheterization - methods Cardiology. Vascular system Cardiovascular Cardiovascular system Confidence intervals Coronary Angiography - methods Feasibility Studies Female Humans Intervention Intubation Investigative techniques, diagnostic techniques (general aspects) Male Medical imaging Medical sciences Middle Aged Multivariate analysis Prospective Studies Radial Artery Radiodiagnosis. Nmr imagery. Nmr spectrometry Regression analysis Studies |
| title | Comparison of the Feasibility and Effectiveness of Transradial Coronary Angiography Via Right Versus Left Radial Artery Approaches (from the PREVAIL Study) |
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